Tuesday, May 27, 2008

Lumpectomy.

Lumpectomy is a common surgical procedure designed to remove a discrete lump, usually a tumor, benign or otherwise, from an affected man or woman's breast. As the tissue removed is generally quite limited and the procedure relatively non-invasive, compared to a mastectomy, a lumpectomy is considered a viable means of "breast conservation" or "breast preservation" surgery with all the attendant physical and emotional advantages of such an approach.


Today, as chance would have it, a surgeon called me into the operating theatre for the treasured opportunity to assist in a surgery which involved removing a breast lump from a patient.

"Benign?" I asked.

"Nope, malignant. This'll save her life."



There was yellow fat sliced away, red blood spurting, and the smell of burning flesh. Surgery is, in its essence, a brutal event. When the evil mass had finally been excavated from the soil of human flesh, the wound gaped open in bloody agony. It seemed an impossible mess to stitch. Yet, very skillfully, the hole was sewn, sealed and plastered over. Neatly, impeccably, beautifully, with the rest of the breast still largely intact.

In the past, most doctors recommended masectomies, where the entire breast was removed, compared to lumpectomies, procedures requiring far more skill and time where the rest of the breast still remains largely intact.

As I watched the surgery and thought about the woman I had met just days ago, I wondered, if perhaps our fears of completely losing such an intimate part of ourselves prevented us from seeking help, and compelled us to live behind the curtain of shame and dread forever.

It may surprise most to know, however, that if one chooses to nip the problem in the bud early on, one has a good chance of requiring a lumpectomy only, and not a complete removal of the breast. The surgeons just need to take away what's bad, but they leave behind what is good.

How the surgeon burnt and excised the tumour reminded me of the way the therapists carved away the cancerous roots of my intimate illness. Skillfully and neatly, and still, leaving behind what was good. I think many people are afraid of losing themselves in the process of seeking help professionally, but the truth is, they only cut away what kills you.

Going under the knife can be scary. Largely naked on the cold, cold operating table, with nothing but a paper-thin gown and some sterile sheets covering you, with possibly your breast exposed and a host of busy staff crowding round you, it is a vulnerable place to be in. It may hurt, and it can sometimes be a messy, even brutal process, but the wound and scar heals, and when the surgery is over, you find not only your breast still largely intact, but your life saved.


You can fight tooth and nail to resist help, as many do, but the more you let go and the more you trust, the more they can step in and get the job done- and done well, too. Going under the knife means completely letting go, allowing someone else to take over. Most people who are ill continue to cling onto control, and until that control is completely handed over, the root of the illness can never be fully removed.

And the surprising thing is- the more you let go, the more you are given in return. They took away my old sources of pride, took away my old sources of control and sustenance, took away my old coping mechanisms, forbade me to eat and exercise the way Ed wanted me to... It was a complete surrender, a complete giving up of control. Yet, at the end, I realised, that all the good parts were returned to me... and more. The joy of eating, the joy of running, the joy of being comfortable with oneself, and the joy of finally... living.


They removed the lump, and left most of the breast largely intact, saving the patient's breast, and life, and most importantly, giving her a new lease of life, with nothing but a fading scar for nostalgic remembrance.


After a few gruelling hours, the surgeon heaved a sigh of relief.


"There, it's done. This'll save her life."



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